Urological Complications of Gynecological and Obstetric Interventions: Management at the Ignace Deen National Hospital—University Hospital of Conakry (Guinea)

Abstract

Introduction: pelvic abdominal surgery may be associated with urological complications requiring reoperation. The aim of this study was to evaluate the urological surgical complications of gynecological and obstetric procedures conducted at the Ignace Deen University Hospital of Conakry in Guinea. Methodology: This was a retrospective, cross-sectional, descriptive study of ten years, from 1 January 2006 to 21 December 2015. Results: Of 14,500 patients hospitalized in the maternity ward during the study period, 31 patients had secondary urological complications during gynecological or obstetric intervention 0.2%). The mean age of the patients was 34.77 years (range: 17 to 58 years). The mean duration of hospital stay was 13.29 days (range: 3 to 28 days). Signs of complication were mainly postoperative abdominal pain (64%, n = 20), vaginal urine leakage (19.35%, n = 6) and vaginal bleeding (9.68% n = 3). The diagnosis was mainly confirmed by ultrasound (70.45%, n = 31). The lesions were primarily ureteric (77.42%, n = 17) or on the urethral wounds (8.12%, n = 12). Urological complications mostly occurred during hysterectomy (41.94%, n = 13) and caesarean section (32.26%, n = 10). Repair procedures included uretero-vesical reimplantation (58.06%, n = 18), vesico-vaginal fistuloraphy (22.58%, n = 7), vesico-uterine fistuloraphy (12.90%, n = 4) and temporary ureterostomy (6.45%, n = 2). Treatment were successful in 28 patients (90.32%) and a lethality of 9.68% (n = 3) was recorded. Conclusion: Urological surgical complications of obstetric gynecological surgeries were

Iatrogenic Lesions of the Ureter Following Obstetric or Gynaecological Surgery Managed at Yalgado Ouedraogo University Hospital: A Series of 14 Cases

“…Renal insufficiency was noted in ten (71.4%) patients. This Open Journal of Obstetrics and Gynecology result is similar to Diallo in Guinea, who found elevated creatinine in 72.2% of patients with iatrogenic lesions of the ureter [9]. In nine out of fourteen cases bilateral ligation of the ureters was found.…”

“…The patients in our study were predominantly young, with an average age of 32.9 years (range 20 -60 years 74.36% of iatrogenic lesions of the ureters were attributable to Caesarian section [9]. Caesarian section is the most common surgical procedure resulting in iatrogenic lesions of the ureters.…”

“…We noted complications as vesico-vaginal fistula in two cases, one case of parietal suppuration, one case of pyelonephritis and one case of hydronephrosis. Diallo reported two (02) cases of vesico-vaginal fistula, three cases of parietal suppuration and one case of vesico-cutaneous fistula [9] (Figures 2-4). …”

Management of Urological Lesions Secondary to Obstetrical Gyneco Surgery in the Urology Department of the Gabriel Toure University Hospital Centre

“…This average delay is lower than that obtained by Diallo, A. B. et al (5 months) [7] but higher than that obtained by Bouya, P. A. (15 days) [1].…”

Management of post caesarean section complications in the general surgery department of the Ignace Deen National Hospital

“…Our results were comparable to those of Saad B et al [3] in Morocco who found a frequency of 63.6%. But superior to those of Diallo FB et al [5] in Guinea who reported 40.55% of complications. This high frequency could be explained by the introduction of free caesarean sections, the existence of residents in the obstetrics gynecology departments in the University Hospital of Conakry and the multitude of clandestine surgeries in our capital.…”